The key literary device in 'My Sister's Keeper' is the use of multiple narrators. Although the story is largely centered around Anna's decision not to consent to the kidney transplant which will save her older sister's life, we are also given the first person perspectives of the rest of the characters involved: Kate, Anna's sister; Jesse, their older brother; their parents Sara and Brian and Kate's lawyer, Campbell Alexander. Through these individual accounts we see that each character has a fierce conviction of their own opinion and what is right in the situation they are all embroiled in.

This device also helps to exemplify the theme of people's love for others and the myriad of ways that it can be shown.